These are latex gloves in the wound room at
Pokhara Regional Hospital,
nicely lined up for re-use after being washed and dried.
On this day, we went to Pokhara Regional Hospital and met Jeny's childhood friend Andu who trained in Russia and is now a young gynecologist, which mostly means she does c-sections (of the 600 deliveries a month at this hospital, about 75% are sections) and hysterectomies for benign disease; nursing “sisters” due all the vaginal deliveries and episiotomy repairs. She doesn't see any cancer patients because at the slightest suspicion of malignancy they send the patient to the regional cancer center near Chitwan. She was in the middle of a 9 am to 2 pm (the next day) on-duty shift and she seemed to competently breeze by case after case after case, including a newborn with its eyelid sealed to its conjunctiva and an unconscious eclamptic woman transferred to the ICU right before we got there. She works over a hundred hours a week most weeks, and still wears little heels to work.
This is the wound room in the hospital.
This is the wound nurse.
In some ways the hospital is like all other hospitals. They have signs about how to prevent swine flu.
And they have crowds of people sitting around, and crowds of people in the hallways looking lost.
The young men (and so far it's only men, but from all social strata) come once a day, show an ID, and a computer automatically states the appropriate dosage and then an attached machine dispenses the appropriate amount into a tiny plastic cup. The patients then have to take the medicine in front of the secretary and a guard and throw the cup into a wastebasket.
It seems so simple, it's incredible to think that every one of those 65 people represents a saved life, not to mention some inevitable drop in crime or lost income (one young man said he had been spending 2000 rupees a day on heroin; this in a country where he probably makes a thousand rupees a month). And the young junkies were so, so sick – microscopically thin and jaundiced and with god knows what kind of infections not to mention the ever-looming risk of HIV. It was really something to see this little cinderblock building as a sanctuary of re-found lives. And so simple – one (very parttime) doctor, one secretary, one guard, one machine, and less than a gallon of methadone a day.
This is the methadone clinic: